HomeMy WebLinkAbout1000-63.-1-12.1 a= �F�� TOWN OF SOUTHOLD
Rental Permit
1120
Owner Christina & Kevin Brennan
Occupied as Single Family Dwelling
Located at 1450 Horton Lane Southold 61-1-12.1
Maximum Permitted Occupancy 2
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
5/7/2024
:ode c nt ffc �
This Notice must be posted by the main entrance at all times
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. 0. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax(631) 765-9502 httas./ wvvw. out.hol(itowrin -ov
MAR 20?4
RENTAL PERMIT APPLICATION �.
Rental Permit Fee $300(Application must be renewed every two year -
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION D6- 7" '' -BLOCK -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name:
.t
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
Telephone Number (s): Daytime Evening Emergency
Property Owner Email Address: [�F-5P-:�E �A � - 8�7 c=9 tA;'\L ' C-z>�
00o
Page 1 of4 _�, y
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number (s): Daytime Evening Emergency
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number (s): Daytime Evening Emergency
Email Address:
SECTION E.
SITE MANAGER INFORMATION: (required for rental Properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any:
Address of Managing Agent (no P.O. Boxes):
Mailing Address of Managing Agent:
Telephone Number (s): Daytime Evening Emergency
Email Address:
Page 2 of 4
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property:
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier (for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, Q the use of each room in the Rental Dwelling Unit
(for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each
room.
For properties with multiple Rental Dwelling Units use "Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier:
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit:
C Use and Dimensionsofch roo Dwelling Unit:
in Rental
1 •� � - Lam-
SECTION G.
INSPECTION:
Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety
inspection by Code Enforcement Official is required. If the owner chooses not to have said
inspection performed by the Town, a certification from a licensed architect, a licensed
professional engineer or a home inspector who has a valid New York State Uniform Fire
Prevention Building Code Certification is required stating that the property which is the subject
of the rental permit application is in compliance with all of the provisions of the code of the
Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and
by the laws adopted by the New York State Fire Prevention and Building Code Council.
0 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
Page 3 of 4
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
COUNTY OF SUFFOLK)
�. /A ertify under penalty of perjury, the following:
1. 1 am the owner of the property identified in "Section A" of this application.
2. The property owner's legal address set forth in "Section B" of this application is my legal
address and I understand the Town will use the address for service pursuant to all
applicable laws and rules. I further acknowledge that I will notify the Town of Southold
Building Department of any changes of address within five (5) days of any changes
thereto.
3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and
agreed to abide by the same.
4. 1 will notify the Town within five (5) business days s to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name: N
Property Owner's Signature:
Sworn to before me this day of � . � _,,,, 20_
Official Notary Public Signature and Original Notary Stamp CONNIE D.BUNCH
Notary Public,State of New York
No.01 BU6185050
Qualified in Suffolk County
Commission Expires April 14,
Page 4 of 4
Feb18, 2024
Town Hall Annex y Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
S" ,L
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a license architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
d rof ssional seal re ui ed or architect or Fn beer licensed Jgome Ins ector must rovid
co V of valid current certi ication
Rental Property SCTM Number:
Rental Property Address: 1450 °fort ns Lan �oUt of
Owner/Name: Kevin Brennan
Rental Dwelling Unit Identifier:
Number &Square footage of each bedroom as depicted in the attached floor plan:
(i.e. Bedroom#1 -100 sq., Bedroom#2-90 sq., etc.)
Bedroom #1 150 s ft
Property Description (Include all improvements indicated on survey)
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it
fully complies with all the provisions of the Code of the Town of Southold, the Residential Code
of New York State,the Building Code of New York State, the Plumbing Code of New York State,
the Fuel Gas Code of New York State, and the Energy Conservation Construction Code of New
York State.
Victor Cornelius III CEO Inspector
Print Name and Title ceo# 1216-0283 OrginalSignature
Please place professional seal:
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BUILDINGTOWN OF SOUTHOLD P .
631-765-1802
lar"imSPECT10" N
( ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETR ION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (F ))
[ ] CODE VIOLATION [ ] PRE C/O ( RENTAL
REMARKS:
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.FORMER�OWNER " N E � ACR� A-
TYPE OF BUILDING
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LAND IMP. TOTAL DATE REMARKS
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Acre._ „wry _ ._... ..: . ..� 1 .........�..., ....., ._. .�..� _..._...
Tillable FRONTAGE ON WATER
Woodland ... .. . .FRONTAGE ON ROAD
DEPTHMeadowland _ _.
House Plat
BULKHEAD
Total DOCK
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Foundation Bath / jDinette
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Ext. Walls Interior Finish ILR
liu°c�ti„ e wr Fire Place Heat DR. j
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Roof Rooms 1st Floor ' BR
pc e Recreation Room Roams 2nd Floor I IN, B �
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UTHOLD PROPERTY RE
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TYPE OF BLD.
PROP CLASS
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TOTAL DATE �`'
LAND IMP. _..... �� r da f_ . .._d
FRONTAGE ON WATER HOUSE/LOT
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BULKHEAD
TOTAL
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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
PRE EXISTING
CERTIFICATE OF OCCUPANCY
No: Z- 28121 Date: 12/17/01
THIS CERTIFIES that the building DWELLING
._..�,..........
Location of Property 1450 HORTON LA SOUTHOLD
(HOUSE........ NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 063 Block 0001 Lot 012.001
Subdivision Filed Map No. Lot No.
conforms substantially to the Requirements for a ONE FAMILY DWELLING
built prior to APRIL 9,1957 pursuant to which CERTIFICATE OF
OCCUPANCY NUN13SR Z- 28121 dated DECEMBER 17, 2001
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
R CHANGE ONLY)
�._FAMILY DWELLING.*-�.. _ � RRECTED 6/31/l0 FOR LOT NUMBER
issued as ONE FAMILY (CO
The certificate is issued to THOMAS & SUSAN MCCARTHY� __�
(OWNER)
of the aforesaid building.
SUF7016K COUNTY DEPARTMENT OF HEALTH APPROVAL N/A,........
ELECTRICAL CERTIFICATE NO. NA_.,.....
pjAnwMERS CERTIFICATION DATED N/A
*PLEASE SEE ATTACHED INSPECTION REPORT.
v
Aut rized Signature
Rev. 1/81
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
HOUSING CODE INSPECTION REPORT
LOCATION: 14SO HORTON LA SOUTHOLD
SUBDIVISION: MAP No-- — LOT (S)
NAME OF OWNER (S): THOMAS & SUSAN MCCARTHY.,..........I—
OCCUPANCY: SINGLE FAMILY THOMAS & SUSAN MCCRA
C''_THY
ADMITTED BY: RUTH LOVE ACCOMPANIED BY: SAME
KEY AVAILABLE: SUfFF. CO. TAX MAP NO.: 6 3 1-:_L2'� ,nwnber_i_s,_now 12.1 8 31 10
SOURCE OF REQUEST: THOMAS SUSAN DATE: 12/17/01
DWELLING:
TYPE OF CONSTRUCTION: WOOD FRAME # STORIES: 1.5 # EXITS: 2
FOUNDATION: BRICK CELLAR: PART CRAWL SPACE:
TOTAL ROOKS: 1ST FIR.: 4 2ND FLR. 3RD FLR-: 0
BATHROOM(S)- 1.0 TOILET ROOMS): 0.0 UTILITY ROOMS)
PORCH TYPE: DECK TYPE. PATIO TYPE: CONCRETE
BREEZEMMY: FlpEpjjLCE.- NO GARA09-
DOMESTIC HOTWATRR- XX TYPE HEATER: GAS Al-RCONDITIONING: —YES
TYPE HEAT: —GAS MARK AIR- HOTHATER;
OTHER: ..........
ACCESSORY STRUCTURES:
GARAGE, TYPE OF CONST. STORAGE, TYPE CONST.
SWIMMING POOL- GUEST, TYPE CONST_- ____............
callm:
VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE
LOCATIO14 C_RIPTlq!__
P C
REMARKS: BP 410G84ZC1,`rZl0?67 (ACCY 3 CAR d3ARAGE WITH NON-HABITABLE 2ND F:,0OR__
BF #27587z- RV SWIn-MiG M
INSPECT® BY: DATE ON INSPECTION. iv_(LoLono
K. BOUFIS TIME START: 9:20 AM END: 10,:00 AN
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-10262 Date: 08/27 10
THIS CERTIFIES that the building ACCESSORY _,—__,,,,,,,,,�,
Location of Property: 1 SotrrHOLD
(HOUSE NO.)
HORTON LA
) STREE�,.m....,., .......�.............._..�
T) (HAMLET)
County Tax Map No. 473889 Section 63 Block 1 — Lot 12.1
Subdivision � ,..,..�,,. Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated ......„w MAY 13 _1980 pursuant to which
Building Permit No. 10684-Z dated MAY 20, 1980
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is GARAGE ACCESSOR Y STRUCTURE (CORRECTED 8127/10 FOR LOT NUMBER CHANGE
_ ......
ONLY) ......._
The certificate is issued to JEROME HACKERT
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL _. ��.!� �....W....„_.
ELECTRICAL CERTIFICATE NO. N/.A__._
PLDMBERS CERTIFICATION DATED .................NLp1,_ ............
Au or i z ed Signature �
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NO: Z-30553 Date: 11/15/04
THIS CERTIFIES that the building ALTERATION _. . ........w.,_
Location of Property: 1450 HORTON LA _ SOUTHOLD
(HOUSE NO. ) (STREET.. ....................._.. ..
(HAMLET)
County Tax Map No. 47389 Section 63 Block 1 Lot 12.1
Subdivision Filed Map No_ Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DUNE 17, 2003 pursuant to which
Building Permit No. 29533-Z dated JULY w 1, m2003
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
NG ACCESSORY
is BATHROOM ADDITION (NO wSHOWER) TO AN EXISTI GARAGE AS APPLIED
�.....w ...� _
FOR. (CORRECTED �.....�.RECTED 8/31/10 FOR LOT NUMBER CHANGE ONLY) ...
_ www. ...�_�,._ . .,..... ww..
The certificate is issued to THOMAS J & SUSAN L MCCARTHY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-03-0054 06 17/03
EIECTRICAL CERTIFICATE NO 3121�n 090'3/,02
PLUMBERS CERTIFICATION DATED 07/13/04 BURTSwRELIABLEIT INC
�Aho;rized Signature
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29158 Date: 12/27/02
THIS CERTIFIES that the building ALTERATIONS
Location of Property= (HOUSE1450} HORTON (STREET) SOUTHOLD
County Tax flap No. 473889 Section 63 Block 1 Lot 12.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated _ JUNE 4, 2 002 pursuant to which
g 4 0.. 13, 2002
�w. dated ..w_.._....___JUNE
Building Permit No_ 28��
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
... �....... CA GARAGE WITH
µµµwONS & ADDITIONS TO EXISTING 1'��""CY NON-HABITBALE 2
is ALTERATIONS
�. 2 7/10 µ µCORREC'�TED FOR TAX MAP LOT`
POOL HOUSE/ E ROOM WITH NO BF�;THROOM (8
UMBER ONLY) _. �.... �._................� ........ �w_. __,.
T MAS i ....._... N M MCCARTHY
The certificate is issued to THOMAS J & SUSAN
{OWNER}
of the aforesaid building.
SUFFOLK COUNTX DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO_ 3121 C19/03 02
plAMMERS CERTIFICATION DATED N/A
Auth ized Sign
ature
Rev. 1/Bl
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-28167 Date: 01 14 O2
THIS CERTIFIES that the building ACCESSORY
Location of Property: 1450 HORTON..LA.. ......_ ..
SOUTHOLD
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No_ 4.7. :.8..89 Section 63 Block 1 Lot 12.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
............
filed in this office dated AUGUST. 3, 2001 pursuant to which
Building Permit No. 27587-Z dated AUGUST 29, 2001
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
(8/27/10 CORRECTED,FORv_LOT NUMBER CHANGE ONLY)
The certificate is issued to THOMAS
J....&wSUSAN M MCCARTHY
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO.
2505
PLUMBERS CERTIFICATION DATED N/A
' 1 �
Aut t rizeci..Signature _........
Rev. 1/81